- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,247.00
| Facility | | $1,013.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.55 / $994.61 / $1,315.39
| Professional | | $865.55 | $994.61 | $1,315.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $980.97 / $1,017.98 / $1,662.70
| Professional | | $980.97 | $1,017.98 | $1,662.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $947.73 / $1,278.42 / $2,030.31
| Professional | | $947.73 | $1,278.42 | $2,030.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,181.54 / $1,582.43 / $1,582.43
| Professional | | $1,181.54 | $1,582.43 | $1,582.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.55 / $1,014.11 / $2,843.00
| Professional | | $865.55 | $1,014.11 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $1,318.70 / $2,452.10
| Professional | | $15.00 | $1,318.70 | $2,452.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.81 / $1,280.85 / $2,108.21
| Professional | | $958.81 | $1,280.85 | $2,108.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.69 / $957.69 / $1,139.69
| Facility | | $957.69 | $957.69 | $1,139.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $918.02 / $972.89 / $1,139.69
| Professional | | $918.02 | $972.89 | $1,139.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $839.96 / $1,152.83 / $1,993.23
| Professional | | $839.96 | $1,152.83 | $1,993.23 |